Due to the popularity of reality television, most people have a good idea on how emergency medical calls are handled. Surprisingly, there is societal awareness around the triage assessment procedures used by EMTs and paramedics arriving on scene. These patient assessments allow quick evaluation of treatment options, and are integral to saving the lives of patients with serious injuries or conditions.
In the United States initiatives and campaigns are building steam to equip patrol cars and train police officers on medical devices and administration of medications. This buildup utilizes the high number of officers available to respond to calls; reducing strain on paramedics. This quick response is vital for time-critical traumatic events, such as the administration of naloxone for opioid-induced overdoses, and the use of automated-external defibrillator (AED) devices for cases of sudden cardiac arrest.
The reasoning behind this is easy to understand. Ambulances are generally dispatched from centralized stations; whereas police patrol entire communities. Emergency dispatchers working in unison with these new police department initiatives allows time-critical treatments to be delivered at a speed which traditional EMS alone could not match.
As such, it is vital that police officers who respond to medical calls and arrive first on the scene are proficient in the process of the patient assessment, as many of the citizens who need this assistance will be unable to communicate, especially in the case of sudden cardiac arrest.
The Patient Assessment
The patient assessment is a three-step process by which emergency responders are able to evaluate patients for injury or trauma upon arrival to the scene, and is the most important aspect of responding to an emergency call. This is simply because a patient cannot be treated until the responder can identify the problem and symptoms being experienced by the patient.
The first stage, or the primary assessment, is used to triage the patient for signs of life threatening conditions and facilitate immediate stabilization. During this stage, the responder should check for airway openness (patency), breathing (rate, quality, presence), and circulation (pulse, blood pressure, and skin perfusion). As well as signs of major trauma, including bleeding, deformity, and disfiguration should also be checked at this point. During this stage, the responder will identify the patient chief complaint symptoms as well as determine the need for deployment of any lifesaving device, such as an AED.
The primary assessment is the point of patient care where deployment of time-critical treatments can determine life or death, therefore all first responders should be trained on how to assess for life-threatening symptoms that present during this stage of the evaluation.
The next stage, known as the secondary assessment, is a “head-to-toe” evaluation similar to the physical exam performed by a physician. It’s used to obtain a more thorough and accurate impression of the patient’s overall condition after he/she has been stabilized during the primary assessment. This portion of the patient assessment is vital to the continuation and streamlining of care upon presentation to a hospital.
The final assessment, the ongoing assessment, is a continuing, periodic recheck of the patient’s condition while en route, in order to evaluate for progress and adjust treatments as necessary. This includes serial vital sign readings approximately every 5-10 minutes for compromised patients or every 10-15 minutes for stable patients. While the latter two assessments will be performed by EMS on the way to the treating hospital, law enforcement officers have the unique opportunity to respond even more quickly.
Benefits of Law Enforcement Response to Emergency Medical Calls
Consequently, as the triage performed in the primary assessment is the most time-critical portion (as related to survivability) it is of great importance for the suffering patient that police officers carry life-saving AED devices in their patrol cars. It is also critical that the officers receive training on how to identify signs of sudden cardiac arrest for which these devices are used.
It is well-established fact that the chances of surviving a case of sudden cardiac arrest are bleak, but they increase exponentially depending upon the ability of the patient to receive time-critical treatment with AEDs and cardiopulmonary resuscitation. The ability of police officers to arrive at the scene of a cardiac emergency more expediently than EMS trucks places a high value on the ability of the responding officer to administer the potential life-saving shock that an AED can provide.
The officer could be patrolling down the same street in which one of these events occur, and respond within a matter of seconds to the patient’s location, whereas the same patient may have to wait several minutes longer for EMS to arrive.
Due to this unique opportunity and positioning, every police car should be outfitted with these life-saving machines, and should not be apprehensive due to concerns of harm done to the patient when deciding to deploy one, as the patient is already clinically dead once the lethal rhythm of ventricular fibrillation causes sudden cardiac arrest. Furthermore, as the survival rate decreases relative to the amount of time lapsed since the event, police officers who are properly trained in recognizing the signs of major cardiac events, such as SCA, can directly impact the chance of the patient surviving the incident.
Upon being the first arrival to the scene, the officer should follow the guidelines established by the American Heart Association for Cardiopulmonary Resuscitation and Emergency Cardiac Care, and immediately deploy the AED device if the patient is unresponsive. The device will do the difficult part on its own, determining if the patient is in the lethal rhythm and delivering the appropriate shock for what it detects.
Officers should be confident in deploying these devices, knowing that, as mentioned above, the patient can only benefit from receiving treatments and can only deteriorate from withholding them.
Due to the topics discussed within this article, careful consideration should be taken by police departments nationwide in taking these initiatives. Failing to equip every officers with life saving AEDs and the proper training to use them can have a detrimental effect on the community in which they serve.
Patients suffering time-critical conditions directly benefit from the timeframe in treatment administration, due to their readiness every officer should be encouraged to respond to emergency medical calls in which there is a suspected possibility of sudden cardiac arrest being the culprit.
Until this becomes the norm, bystanders who witness these events should be aware, looking for close police cars with signage indicating that they have an AED onboard, asking that officer to help. This is the least we can do until a time in which all police cars are equipped with these devices.
Kaiser, C. (2011). Life Under the Lights: Eight Ways you can Ace your Patient Assessment. Retrieved from http://www.lifeunderthelights.com/about-the-blog/about/#sthash.7p2efUaj.dpbs.
Sudden Cardiac Arrest Foundation. (nd). Sudden Cardiac Arrest Treatment. Retrieved from http://www.sca-aware.org/sudden-cardiac-arrest-treatment.
 The three step process involves a primary assessment, a secondary assessment, an ongoing assessment as part of a comprehensive effort to stabilize, if possible, but also to treat, if necessary, on route to the hospital. Retrieved from http://www.lifeunderthelights.com/2011/06/13/eight-ways-you-can-ace-your-patient-assessment-ems/#sthash.okAei0qz.DqEZMbIi.dpbs.
 During secondary assessment, an EMS provider will assess all of the system of a patient’s presentation, including skin perfusion (again), head, eyes, ears, nose, and throat (HEENT); as well as respiratory, cardiac, neurologic, etc. This is similar to the more detailed physical examination that will be performed by an emergency room physician. The ongoing assessment allows for treatment to be adjusted or maintained while in route to the hospital. This is important, because EMS providers are in constant contact with the presentation hospital and will be able to apprise the staff at this receiving facility of
 Approximately 10% of SCA patients die without AED/CPR intervention. When bystander CPR/AED treatment is administered, this survival rate increases to approximately 40%. Retrieved from http://www.sca-aware.org.